The key players in Republicans’ last-ditch effort to kill the Affordable Care Act – Washington Post

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It wouldn’t be 2017 if congressional Republicans weren’t a few votes shy of passing legislation to kill the Affordable Care Act.

And it wouldn’t be 2017 if there weren’t dual cases to be made that they may actually succeed — and that the likelihood of success looks extremely thin.

The advent of the Graham-Cassidy plan means the GOP has another chance to rebound from its blistering defeats on health care and fulfill its long-standing promise to overhaul the ACA. Doing this could take health coverage or medical benefits from millions of people, but with leaders desperate for a strategic victory and less than two weeks to pass budget-related legislation with 51 rather than 60 Senate votes, they are working hard to persuade undecided lawmakers to vote yes.

Success is not guaranteed, of course. Notably, Congress’s nonpartisan budget analyst has not said how much the bill would cost or how many people could lose health insurance. But proponents of Graham-Cassidy said they had momentum as the week began. Remember: The measure will die in the Senate only if more than two Republicans vote no.

As the next two weeks unfold, here are the players to watch, starting with the senators expected to determine the bill’s fate.

Sen. Lisa Murkowski (R-Alaska) speaks to reporters in early September. (Joshua Roberts/Reuters)

• Sen. Susan Collins (R-Maine)

Collins is considered the most likely of any Republican senator to vote no on the legislation, which would transfer billions in federal health-care spending and policy authority to states. Collins has expressed concerns about it, according to the Bangor Daily News, and Planned Parenthood’s strong opposition to the bill could give her further pause.

During the last health-care vote, Collins didn’t hesitate to be one of three Republicans to vote against the legislation. Without a significant rewrite (hint: losing a provision to defund Planned Parenthood), it’s hard to see her switching positions on a measure that critics have called even more harmful.

• Sen. Lisa Murkowski (R-Alaska)

Like Collins, Murkowski was one of the three Republicans to vote against the GOP’s last attempt to undo the health-care law. And like Collins, she received warm thanks in her state after taking that vote. Even with the elimination of a provision to defund Planned Parenthood, it’s not clear how the new bill, which by some accounts would negative affect coverage for even more Alaskans, would move Murkowski to yes. But she tends to be somewhat more open to legislative dealmaking. So far, she has been silent on Graham-Cassidy.

• Sen. Rand Paul (R-Ky.)

Paul announced his opposition to the bill on Friday, calling it “Obamacare Lite” and rebuffing an offer from co-sponsor Bill Cassidy (R-La.) to go over the details. On Monday, he said that nothing could change his mind.

Yet Paul’s past comments suggest that he could be open to cajoling, particularly if leaders are one vote short or the bill undergoes changes.

“If they cannot get to 50 votes, if they get to [an] impasse, I’ve been telling the leadership for months now that I will vote for a repeal. It doesn’t have to be 100 percent repeal. . . . That’s what I want, but if you offer me 90 percent repeal, I’d probably vote for it. I might vote for 80 percent repeal,” Paul told ABC News in June.

• Sen. John McCain (R-Ariz.)

McCain stopped the GOP’s last health-care push with a dramatic thumbs-down on the Senate floor. This time, he’s vacillating in a way that suggests his vote is up for grabs.

When asked about Graham-Cassidy earlier this month, McCain said he would support it — then backtracked in a statement about assessing its effect on Arizona. McCain also said he wanted to consult with Arizona Gov. Doug Ducey (R), who has since endorsed the plan.

Not all signs point to McCain voting yes. On Sunday, he cautioned Republicans against the instinct to “ram through our proposal” without Democratic votes and complimented a separate, bipartisan effort to draft health-care legislation within the Senate Health, Education, Labor and Pensions Committee.

That effort is “doing fine,” McCain told CBS. “Bring it to the floor. Have debate. Have amendments.”

• Other possible Senate swing votes

Collins, Murkowski, Paul and McCain are worth watching closely as the week proceeds. But other Republicans could come out in opposition to Graham-Cassidy, throwing leaders’ math into doubt.

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